Erosion-inhibiting potential of calcium pre-rinse plus fluoride rinse

Objective: It has already been shown that calcium (Ca) rinse used prior to fluoride (F) rinse increases the formation of Ca-mediated deposits in saliva and may enhance the cariostatic effect of F products. Although possibilities are that the same benefit may be exerted under erosive conditions, such hypothesis has not been tested yet. This pilot in situ study was designed to evaluate whether Ca rinse given before F rinse would increase enamel protection against erosive episodes.

Method: Fourteen volunteers participated in this hybrid split-mouth parallel study wearing a palatal device containing 4 sterilized bovine enamel slabs, for 10 days. Half of the participants followed protocol A: daily rinse with a Ca lactate solution (150mmol/L, 1min), followed by NaF solution (12mmol/L, 1min), while the other half followed protocol B: daily rinse only with the NaF solution. Appliances were removed from the mouth and one side of the palatal appliance was exposed to an erosive challenge (0.05M citric acid, 90s); the other side served as negative control (no erosion). Specimens were evaluated for wear depth with an optical profilometer (micrometers).

Result: Kruskal Wallis (p=0.003) and Dunn test showed that when Ca+NaF were used prior to erosive challenges, enamel wear (median=-0.02) was similar to that obtained for uneroded groups. Rinse with NaF only resulted in the highest wear (median=-2.27).

Conclusion: Pre-rinse with Ca lactate may increase the protection exerted by NaF against erosion.